U.S. Cancer Deaths Continue to Decline

But too many people are still smoking and not eating well or exercising, report says

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TUESDAY, April 10, 2007 (HealthDay News) -- The war on cancer continues to pay dividends with annual deaths from the disease declining in the United States, a new report shows.

But there are worrisome signs that the efforts to conquer cancer are stalling on several fronts, with declines in tobacco-cessation rates leveling off, too few people not taking advantage of timely screening tests, and far too many individuals not eating enough fruits and vegetables or getting sufficient exercise, according to the report from the American Cancer Society.

"We have been seeing a great deal of progress in terms of mortality rates and total deaths from cancer," said Elizabeth Ward, director of surveillance research with the American Cancer Society's department of epidemiology and surveillance research. "A lot of that progress has come about from public health intervention, including declines in tobacco-related cancer and declines in colorectal cancer mortality.

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"A number of public health early detection and prevention programs that the cancer society and other groups have advocated are really making a difference," she added.

However, the cancer society is concerned that progress won't continue at the same pace as in recent years. Money spent on smoking-cessation programs has stopped increasing, and the decline in smoking has leveled off. In addition, the number of Americans getting screened for cancers, such as breast and colorectal malignancies, hasn't increased, Ward noted.

"Despite evidence that these programs are successful, they are not being sustained," she said.

According to the report, Cancer Prevention & Early Detection Facts & Figures 2007, the death rate from all cancers combined has decreased 13.6 percent from 1991 to 2004. And the number of cancer deaths dropped by more than 3,000 from 2003 to 2004, the most recent year for which statistics are available. This marks the second straight year that the number of deaths decreased despite an increasing and aging population.

Ward thinks that anti-smoking programs must be beefed up. Also, more women need to get regular mammograms to detect breast cancer. "These are the things we are focusing on this year," she said.

This year, about 168,000 cancer deaths will be caused by tobacco. And an estimated 186,550 of the 559,650 cancer deaths expected in 2007 will be attributable to poor nutrition, overweight and obesity, and physical inactivity. Many deaths from breast, colon, rectal, and cervical cancer could be prevented by greater use of screening tests, according to the report.

Other findings in the report include:

Only 54.9 percent of women 40 and older had a mammogram in the past year, and 69.7 percent of women over 40 had one in the past two years. The percentage of women who reported having a mammogram within the past two years did not increase from 2000 to 2003.

Smoking among adults and teens has leveled off, likely due to increased spending on marketing and promotion by tobacco companies and reductions in funding for tobacco-control programs.

Over the past 20 years, the rate of obesity has tripled among teens, from 5 percent to 17.1 percent. Obesity in adults doubled from 15 percent in 1976 to 33.3 percent in 2004.

Although screening could cut colorectal cancer deaths in half, less than half of people 50 and older have had a recent colorectal screening test.

Overexposure to the sun's ultraviolet rays will cause more than one million cases of basal and squamous cell cancers and 59,940 cases of malignant melanoma in 2007.

One cancer expert agrees that quitting smoking, maintaining a healthy weight, eating a healthful diet and being physically active are all important steps in preventing cancer.

"It's remarkable that there were more than 3,000 fewer cancer deaths in 2004," said Dr. Maureen Killackey, the deputy physician-in-chief and medical director of the Regional Care Network at Memorial Sloan-Kettering Cancer Center, in New York City. "This is really hopeful that we are seeing a decrease in death rates from cancer in the United States."

This decline in deaths is due to basic measures, Killackey said. "The biggest reason for the decrease is the decreases in tobacco use," she said. "There are at least seven types of cancer related to tobacco use -- it's a lot more than just lung cancer. Forty percent of cancer deaths are due to tobacco-associated cancers. So, even a drop in the smoking rate by a couple of percentage points has a tremendous impact."

"There is really nothing sexy about cancer prevention," Killackey added. "It's really living with moderation. Another 15 percent of cancers are due to lifestyle," she said. For example, obesity increases the risk for breast and colorectal cancer. In addition, obese people who develop cancer don't do as well as people who are normal weight, she said.

Yet, too many Americans aren't taking the necessary steps to live a healthy lifestyle that can limit their chances of getting cancer. A study released last month by the U.S. Centers for Disease Control and Prevention found that 62 percent of the study participants didn't eat any fruit daily, and 25 percent didn't eat vegetables daily. Overall, there was no improvement in Americans' fruit consumption, and there was a small decrease in vegetable intake during the study period, from 1988 to 2002.